Risk factors for recurring hepatocellular carcinoma differ according to infected hepatitis virus - An analysis of 236 consecutive patients with a single lesion

Patients with hepatocellular carcinoma (HCC) frequently experience intrahep atic HCC recurrence even after complete ablation of primary lesions. Becaus e the oncogenic process may be different for hepatitis B viral (B-viral) an d hepatitis C viral (C-viral) HCC, the present study was conducted to eluci date the factors contributing to HCC recurrence with respect to the infecte d hepatitis virus. Two hundred thirty-six patients with a single HCC lesion who underwent complete ablation of the tumor by PEIT and/or PMCT dr surgic al resection at Tokyo University and its affiliated hospitals from 1993 to 1997 were enrolled. The patients were classified into 3 groups: the B-viral group, C-viral group, and NBNC group. After complete removal of tumors, th e patients were followed for a mean period of 39 months. The factors contri buting to HCC recurrence were analyzed by univariate and multivariate analy sis using the Cox proportional hazard model. The rate of intrahepatic recur rence in enrolled patients at 1, 3, and 5: years was 19%, 50%, and 64%, res pectively. The intrahepatic recurrence rate in C-viral and B-viral HCC was higher than that in the NBNC-related HCC. Fibrosis staging, pathological gr ading of HCC, and serum AFP levels were significantly linked to intrahepati c recurrence by univariate analysis, and fibrosis staging was strongest in the multivariate analysis for C-viral HCC (P =.004). In contrast, fibrosis staging did not affect the recurrence in B-viral (P =.51) and NBNC-related (P =.77) HCC. Risk factors for HCC recurrence differed according to the inf ected viral state.